Can airway obstruction be estimated by lung auscultation in an emergency room setting?
| Autor: | Bernd M. Leimenstoll, Michael Tamm, Benedict Martina, Gian Koch, Thomas Dieterle, André P. Perruchoud, Jörg D. Leuppi, Irène Wildeisen |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty Vital Capacity Physical examination urologic and male genital diseases Sensitivity and Specificity FEV1/FVC ratio Predictive Value of Tests Forced Expiratory Volume Internal medicine Humans Medicine Aged Lung medicine.diagnostic_test business.industry Respiratory disease Auscultation Middle Aged respiratory system Airway obstruction medicine.disease respiratory tract diseases Surgery Lung auscultation medicine.anatomical_structure Normal lung Cardiology Female business circulatory and respiratory physiology |
| Zdroj: | Respiratory Medicine. 100:279-285 |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2005.05.005 |
| Popis: | SummaryObjectiveLung auscultation is a central part of the physical examination at hospital admission. In this study, the physicians’ estimation of airway obstruction by auscultation was determined and compared with the degree of airway obstruction as measured by FEV1/FVC values.MethodsTwo hundred and thirty-three patients consecutively admitted to the medical emergency room with chest problems were included. After taking their history, patients were auscultated by an Internal Medicine registrar. The degree of airway obstruction had to be estimated (0=no, 1=mild, 2=moderate and 3=severe obstructed) and then spirometry was performed. Airway obstruction was defined as a ratio of FEV1/FVC 50%), moderate (FEV1/FVC 30%) and severe (FEV1/FVC 70%). Spirometry showed a mild obstruction in 51 patients (21.9%), a moderate obstruction in 27 patients (11.6%) and a severe obstruction in 20 patients (8.6%). There was a weak but significant correlation between FEV1/FVC and the auscultation-based estimation of airway obstruction in Internal Medicine Registrars (Spearman's ρ=0.328; P70%), airway obstruction was wrongly estimated as mild in 42 patients, as moderate in 34 patients and as severe in 6 patients, respectively. By performing multiple logistic regression, normal lung auscultation was a significant and independent predictor for not having an airway obstruction (OR 2.48 (1.43–4.28); P=0.001).ConclusionUnder emergency room conditions, physicians can quite accurately exclude airway obstruction by auscultation. Normal lung auscultation is an independent predictor for not having an airway obstruction. However, airway obstruction is often overestimated by auscultation; thus, spirometry should be performed. |
| Databáze: | OpenAIRE |
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